Riding in Cars With Researchers – Cognitive Overload

Riding in Cars With Researchers – Cognitive Overload

Hello, I’m Dr. Jeff Kingsley and welcome to another edition of Riding in Cars With Researchers. Today we’re going to talk about cognitive overload – what it is and why you should care. I believe I mentioned the concept of cognitive overload when I was doing the video on vicious versus virtuous cycles and I know I’ve spoken about it at several of the recent conferences where I’ve been presenting.

What is Cognitive Overload?

Cognitive overload is a very real phenomenon. It’s a phenomenon that basically means the more input in a given period, the lower the output. The more things I pay attention to at the same time, the less I’m able to maintain my concentration and produce a high-quality output. There is great data that shows that multitasking isn’t real. Human beings cannot multitask. It’s artificial to think that you can do multiple things with concentration at the same moment in time. Your concentration actually has to shift focus from one thing to another. Unconscious behavior, however, continues because that doesn’t require your conscious focus. It just simply happens.

But cognitive overload is real. Imagine a neurosurgeon in the midst of neurosurgery and people are asking this person to solve complicated math equations at the same time, while there’s music in the background (that the surgeon doesn’t really like) and nurses are talking about completely different things (sidebar conversations), and somebody else is reading the surgeons text messages to him. Quality would go down. Cognitive overload. Doctors struggle with this all day, every day.

Examples of Cognitive Overload

One of our Investigators had an appointment with me at 4pm. I called him at 4 to discuss a non-alcoholic fatty liver disease trial that we’re coming up on; to discuss the protocol, his review of the protocol and patient populations and the use of the Fibroscan device. So, we had this appointment at 4:00pm and he was prepping for that appointment, but when I called him at 4 he asked if he could call me back as he was on his way to the OR. He was on his way into the OR, unplanned, because a surgeon was operating on a patient and found a very large gallstone and needed him to determine if he could take it out as an outpatient procedure or if they needed to pivot and remove the gall stone in the midst of a different procedure that they were there to do at that time. This doctor is a gastroenterologist and he’s seeing outpatients, he’s doing hospital rounds, he’s doing procedures (endoscopies), and has on-call responsibilities. He’s a Principal Investigator and he has to pay attention to I/E criteria and he’s got an inbox filled with emails from me, CRAs, and project managers and from venders with usernames and passwords. All of that is cognitive overload.

When I started this video today, I was thinking about doing a video on cognitive overload and I was at the entrance ramp. I was at a stoplight and I was getting ready to hit the record button, but I didn’t. Why? Well because I would be moving down an entrance ramp with the 20 other cars that were around me and then merging onto a highway while driving and thinking through cognitive overload and trying to have a coherent message. And I knew that my quality would go down if I tried to do so. I made a conscious decision to wait until I was already on the highway to press the record button and then I could begin having a conversation with you.

What is Cognitive Overload in Research?

As an industry, we need to recognize that cognitive overload is real and if we want a better output, we need to work hard to decrease the inputs – to simplify what we’re doing as an industry. Not to simplify for simplification sake. Not to simplify to make an Investigator’s life easier. To simplify because ultimately, we all win. There’s a quote about how it’s easy to make things complicated and it really is. I make things complicated. We as an industry have excelled at making things complicated. Making things complicated is easy, making things simple is hard. And that’s why we don’t run into simplification all that much. If we can all agree that if we simplify the clinical research endeavor, we will improve enrollment, quality, timelines, and customer service (EQTCS), and we will ultimately get innovation to the patients that desperately need it faster and ultimately more cheaply. This is a win for patients, our taxes, insurance, industry – a win for everyone.

If we can all agree that simplification will have all of those ripple effect benefits, then it’s a challenge we need to take on now. TransCelerate’s Shared Investigator Platform (SIP), requires a single sign on, and then you have the ability to share documents in a singular portal, and access all of the other vendor portals through a single portal. This is an example of a group of large pharmaceutical companies getting together and saying, “hey, we need to simplify some of this.” The Shared Investigator Platform (SIP) is a great example of an attempt at simplification. Adoption of SIP is increasing, but we, personally, are not there. I don’t have a single trial that’s on SIP today, nonetheless, I support it and we’re getting there. We need to do much more than that. We need to look in all of the nooks and crannies. What other things could we be doing to reduce cognitive overload as an industry so that we improve EQTCS?

There’s your thought for the day – cognitive overload. What’s in it for you? Everything. The workload will go up before it goes down. The act of trying to simplify is hard. Ultimately, we all win when we achieve simplification, and if we start today, we will be there in a year or two or three and it’s worth it.